There is molecular evidence that endometriosis has a negative impact on the ovaries, although the exact pathophysiology concerning endometriosis-associated subfertility is not known. The negative impact on the tubo-ovarian unit can be directly by distorting the anatomy, indirectly by invoking inflammation or by oxidative damage with poorer-quality oocytes. Endometriosis even seems to have a negative effect on pregnancy outcome after in vitro fertilization.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937065PMC
http://dx.doi.org/10.1007/s00404-016-4049-2DOI Listing

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